Nursing Care at the End of Life: What Every Clinician Should Know

Reviewed by Marty (Martha) Fabian-Krause, RNBS, Adjunct Clinical Instructor, Rogue Community College on 11/29/22

Comprehensiveness rating: 5 see less

From history, definitions, trajectories, stages of death, hospice and palliative care , interpersonal communication nurse to patient, symptom management, bereavement, this text is very thorough and progressive.

Content Accuracy rating: 5

No issues encountered.

Relevance/Longevity rating: 5

Totally current in time and cultural relevance for today’s healthcare.

Clarity rating: 5

Written clearly with current accepted terminology.

Consistency rating: 5

This text follows a progressive style with each section building upon the next. The topics can be used independently also.

Modularity rating: 5

Can be easily assigned in smaller sections or changed in order depending on the class structure.

Organization/Structure/Flow rating: 5

This text is well organized with an opening introduction, the body of work, and an easily to understand closing.

Interface rating: 5

The grafts and charts are relevant and easy to comprehend. They are included in most sections.

Grammatical Errors rating: 5

No grammatical errors noted.

Cultural Relevance rating: 5

The writing style includes a wide population base with some detail to further research with reference to particular cultural groups available.

Comments

Important material about medical ethics, withholding, withdrawing medical care discussed and clarified in closing content. Very relevant for healthcare practitioners. Special consideration to grief and loss and the work of Dr Elisabeth Kubler Ross.

Reviewed by Nicole Trainer, Assistant Clinical Professor of Nursing, The George Washington University on 1/31/22

Comprehensiveness rating: 5 see less

The book is very comprehensive and provides all details a novice nurse needs to know without overcomplicating the clinical situation.

Content Accuracy rating: 5

The book is accurate and provides evidence-based interventions for nursing practice within the hospital and community settings.

Relevance/Longevity rating: 5

This book is extremely relevant to nursing practice. It makes a great point that only 2% of nursing curriculum focuses on end of life however, the vast majority of nurses will need to know how to care for the dying patient and family.

Clarity rating: 5

The book is clearly written and provides clear guidance to care for patients and families at the end of life.

Consistency rating: 5

The book is consistent in terms of terminology and framework. The afterward provides a real-life interview of the author that addresses the great need for resiliency in nursing practice relating to death and dying. The final chapter provides resources.

Modularity rating: 5

I really appreciated the division of reading with "Anticipation", "In the moment", and "Afterwards". These sections make a lot of sense when you are working with dying patients. The anticipation section prepares students for the in-the-moment part which would be the most anxiety-approaching aspect of dying.

Organization/Structure/Flow rating: 5

The book's organization is clear and logical.

Interface rating: 5

The text was easy to navigate and broken into chapters that were placed in logical sections.

Grammatical Errors rating: 5

No grammatical errors were found.

Cultural Relevance rating: 4

The book references different spiritual and cultural beliefs but does not detail specific races, ethnicities, and backgrounds. There are no cultural insensitivities noted and the book is in no way offense.

Comments

This textbook is exceptional and the content should be integrated into the curriculum of all nursing schools. The writing is concise, meaningful, and approaches a difficult topic in a positive way. Communicating healthcare wishes in a careful manner during the dying process is explained thoroughly.

Reviewed by Laura Mallett, Assistant Director of Nursing, Neosho County Community College on 6/3/21

Comprehensiveness rating: 5 see less

The book covers all areas of the End of LIfe that a clinician should be aware of. The information would be good for novice nurses.

Content Accuracy rating: 5

We do a Death and Dying course as an elective in the program and use the online course. Comparing the two I would say this covers information well and actually goes presents it in more detail.

Relevance/Longevity rating: 5

Very relevant to nursing education.

Clarity rating: 5

Written very well.

Consistency rating: 5

Consistent with the resources and best practices that I could see.

Modularity rating: 5

The book can be divided into modules easily.

Organization/Structure/Flow rating: 5

The organization of the book is sequential and makes sense.

Interface rating: 5

I think it is well written and no distractions noted

Grammatical Errors rating: 5

None that I saw in the review process.

Cultural Relevance rating: 5

I did not see anything that would alert me to cultural insensitivity.

Comments

I feel this would be a good resource or even book to use within the curriculum for nursing programs

Reviewed by Linda Mollino, Director of CTE Program, Oregon Coast Community College on 1/11/21

Comprehensiveness rating: 4 see less

Overall, this book provided a comprehensive look at the role of nursing care in
end-of-life care. Much of the content is presented in a detailed format and presented at a level that an undergraduate nursing student would understand and apply the content into their clinical practice. However, I would have liked to see additional information on the non-pharmacological approaches to pain and symptom management.

Content Accuracy rating: 5

No errors were noted with regard to content, but it does present content from a single clinicians' point of view. The references do back-up the content.

Relevance/Longevity rating: 5

Content is current and will stand-up to time. it is important for the reader to understand that laws could affect the approaches to care such as the use of marijuana based on state and federal laws and new approaches to pain and symptom management.

Clarity rating: 4

Very readable for an undergraduate nursing student. The charts presented were good but the use of tables and charts whenever possible to keep the student engaged in the topic is very important. So additional resources would have assisted in solidifying the content for the reader. The use of outcomes at the beginning each chapter and focus statements at the end of the chapter is very effective for solidifying the chapter content for the reader.

Consistency rating: 5

The information presented was consistent, through this probably is due to the fact that it was presented with one author's voice. However, there were no inconsistencies noted in the information presented.

Modularity rating: 5

The way the text is outlined, it can easily be broken up into smaller modules. This would be very effective for the instructor in dividing up content lessons. The book would totally support this approach. Example: historical approach vs. symptom management.

Organization/Structure/Flow rating: 4

The information was presented in a very organized matter, bringing in an historical perspective, and moving through the important topics such as palliative care vs. hospice care, on to pain management and the emotional/spiritual aspects of care at the end-of-life. One element that would have added to the flow of the content is case presentations and/or scenarios.

Interface rating: 5

There were no interface issues. The book flows well in a number of interface programs. The charts are readable, pages remain consistent with the table of contents and the reference links are accessed in new tabs thereby locking the content and allowing the readers to maintain where they were within the book.

Grammatical Errors rating: 5

No errors were noted. Again, the flow of the book makes it readable for an under-graduate nursing student.

Cultural Relevance rating: 4

Although the chapter on "Diversity in Dying" is done well, it would have been more effective if some of this content was included throughout the book such as in the chapter "Initiating Conversations about Goals of Care.

Comments

Overall, this book is effective in presenting the concept of end-of-life care. Case studies would have brought the information home to the reader. However, the last part of the book that focuses on "lessons learned" does solidify the information presented. The hope is that book will engage the reader, encouraging them to look at other resources in the care of patients at the end of their lives.

Reviewed by Thomas Dombrowsky, Clinical Assistant Professor, University of Texas at Arlington on 2/19/20

Comprehensiveness rating: 3 see less

The book addresses all the major areas of end of life care. I would have liked to see more specifics about symptom relief and about non-pharmaceutical methods for addressing pain.

Content Accuracy rating: 4

No errors of fact were detected. The content was presented from the perspective of the author's experience, but due to the nature of the case that is what one would expect.

Relevance/Longevity rating: 4

The content is up to date. However, state laws regarding end of life care are rapidly evolving. This is especially true in the area of assisted suicide. The book mentions states that currently allow physician assisted euthanasia but does not acknowledge that this is an area where law and societal norms are rapidly changing.

Clarity rating: 5

The text is quite readable. Technical terms are explained as soon as they are introduced. The objectives for each chapter give a clear idea of what to expect, and content is appropriately summarized at the end.

Consistency rating: 4

There is only one author, so the style is highly consistent.

Modularity rating: 4

Each chapter stands on its own. Chapters could be assigned individually or used along side content from other sources.

Organization/Structure/Flow rating: 4

The organization is logical and clear. Content could easily be used in order in a course focusing on end of life.

Interface rating: 4

The interface is clean. Appropriate tables are used. There is a lack of diagrams or pictures, but diagrams and pictures would not necessarily be helpful.

Grammatical Errors rating: 3

The author uses gender inclusive pronouns but there are some inconsistencies in their use that are a little distracting.

Cultural Relevance rating: 4

The text is inclusive and no insensitivity was detected. However the content was quite specific to US law and customs, so it might be less useful in an international educational setting.

Comments

I was disappointed by the section on pain control. The author led with pharmaceutical interventions. This is of course what is usually done, but I would have liked to see an emphasis on non-pharmaceutical interventions. Actually little was said about non-pharmaceutical interventions, and practical suggestions along this line were not offered. Most patients do indeed need medications, but too often the non-pharmaceutical interventions are an afterthought when medications are not effective rather than leading with the non-pharmaceutical interventions and including medications as well in a comprehensive plan of care. The section could be strengthened by adding content on the physiology and psychology of pain transmission and how pain control methods work.
The chapters on emotional and spiritual distress and on communication were excellent.

Reviewed by Lisa Kuppler-Lee, Nursing Faculty, Radford University Carilion on 2/14/20

Comprehensiveness rating: 4 see less

The on-line book is very informative on most aspects of "end-of-life-care" (ELOC). Unfortunately, it provides minimal information regarding Advanced Directives and Healthcare Power of Attorney. These two issues are becoming more of a problem in the hospital setting. Patients and/or family members are asked if an Advanced Directive or Power of Attorney is available on admission.

Content Accuracy rating: 5

EOLC is so important. This text is error-free. The author provided unbiased information based on the different professional journals and books cited and referenced. The publications are well-known medical and nursing journals.

Relevance/Longevity rating: 5

The book was up-to-date when it was published and EOLC will never become obsolete. In fact, its relevance increases as our life expectancy increases. Based on how the author arranged the text, the updates would be easily implemented.

Clarity rating: 5

Although the text is written primarily for healthcare professionals, an educated layperson could easily understand the book.

Consistency rating: 5

The material presented followed a consistent understandable format. At the end of each chapter was a section titled "What you would know". This provided highlights of the chapter in a few sentences.

Modularity rating: 5

The modular design of the various chapters make a strong pulling point for this book. Each chapter can stand alone by itself or have the flexibility to be part of a module. You can assign a few chapters as a module to be part of their current assignment. The book can be used as reference material for an assignment.

Organization/Structure/Flow rating: 5

The book is very well organized. Its starts with history of EOLC and ends with breavement.

Interface rating: 5

I used the PDF version. The text was easy to read and the various charts were significant to the chapter. The charts were clean without any distortion.

Grammatical Errors rating: 5

No grammatical errors were noted.

Cultural Relevance rating: 4

The book was not insensitive or offensive. The book only provided a chart on the different cultural/religious beliefs pertaining to care of the patient after death. Many of the different cultures/religious have rituals taking care of the patient prior to death. More in-depth information needs to be provided about the different cultures/religious groups.

Reviewed by Laurie Schroder, Program Coordinator & Assistant Professor, East Tennessee State University on 10/6/19

Comprehensiveness rating: 4 see less

The text is comprehensive in its scope but only touches on many topics which would benefit from more depth, such as ancillary pain treatments and assessment tools utilized with patients. While the author is obviously knowledgeable about the topics introduced, many may be unfamiliar to readers and a list of additional reading or references for those interested in pursuing more information might be helpful. It is understood that many of these topics are beyond the scope of this text, which makes this text both more readable, and slightly less comprehensive.

Content Accuracy rating: 4

Overall, the text is accurate and material presented is supported with current research. Occasionally, an inaccuracy occurs, such as a statement on page 69 that seems to indicate that physical tolerance of a medication is analogous to withdrawal, but this seems to be the result of an editing error more than one of inaccurate facts.

Relevance/Longevity rating: 5

The content is up-to-date and relevant, and is unlikely to become obsolete quickly as it does not serve primarily as a scientific text. Although some statistics are included, they are not terribly important in terms of bolstering any textual arguments.

Clarity rating: 5

The text is clear and accessible, with very little in the way of professional jargon. The author generally makes her point and provides sufficient anecdotal or research support for it. In some cases, the writing style is almost too informal, and weaves back and forth between present and future perfect progressive tense, or between addressing the reader directly as "you" and more formal technical-style writing.

Consistency rating: 4

The text is generally internally consistent. Those minor inconsistencies that exist (e.g. a suggestion that patients be included in meals and encouraged to eat their favorite foods, vs. a later suggestion that patients be given bland, cool foods to eat) are easily sorted out by individuals with a healthcare background, and could be readily explained by a knowledgeable instructor. The text is generally informal and written to relate the author's extensive personal experience with the dying and their families, and reads as a personal communique with some current evidence-based information and medical background added in as support. If intended for that use, the book would serve well; if intended to provide a thorough presentation of the pharmacologic, therapeutic, rehabilitative, etc. framework for death and dying, there is insufficient breadth and depth present.

Modularity rating: 5

This text would lend itself easily to being divided into easily read and digested units for a course. Although perhaps not entirely comprehensive, it would serve as a good jumping-off point for material that permitted students to self-assess their own biases related to death and dying, palliative care, and grief.

Organization/Structure/Flow rating: 4

This text is well-organized, beginning with a historical (if purely Westernized) view of end-of-life care and ending with a chapter on bereavement, and includes chapters that cover illness trajectories, frameworks of death and dying, palliative and hospice care, and an in-depth section related to the relationship, both professional and personal, that exists between the nursing caregiver and the dying patient.

Interface rating: 5

I elected to review the pdf version of the text, which downloaded without difficulty, was easy to navigate, presented with no interface errors, and with which I was able to use the search tool.

Grammatical Errors rating: 3

Although the text does not contain notable, consistent grammatical errors, it is written in the style of a thesis paper, and at a relatively basic reading level. Some stylistic elements may grate on the college-level reader, such as references to inanimate systems that "grow and develop", "less" and "fewer" being used interchangeably, references that are unclear (e.g. "those diseases"), and other word and phrase choices that would be well-served by some revision. Additionally, the author tends to move freely among tenses within any given paragraph, which slows reading and comprehension. Clunky sentences, such as, "While there are certain things that are not warranted in a nurse's role to talk about, such as delivering bad news or a terminal prognosis, there are plenty of other informative things that can be discussed with the patient.", may cause the reader to pause unnecessarily. The occasional missing apostrophe, misused term, and redundancy ("also", "as well", "in addition" - more than one present in one sentence) would also have been eliminated by a good editor. Finally, as a note regarding writing style, moving from an informal manner similar to direct discussion with the reader ("So now you have a basic understanding about illness trajectory") to a formal style, adds an additional obstacle to making this text easy to read.

Cultural Relevance rating: 2

Although the text includes a chapter on "Diversity in Dying: Death across Cultures", it only serves to outline traditional American death and burial traditions and to provide a table of abbreviated beliefs from different religious traditions. The text does urge individuals working with patients and families from different cultures to be intentional about learning more about their values and traditions.

Comments

This book is an easy read, and while it has some stylistic issues, these are minor. It does a very good job of presenting a realistic personal perspective, from an experienced nurse, of the many facets included in the work (and calling) of providing care to patients and families during a difficulty period in their lives.

Reviewed by Monica Schibig, Associate Clinical Professor, University of Missouri on 1/15/19

Comprehensiveness rating: 4 see less

This text does a respectable job of including all the key elements for one's understanding of end of life care (EOLC) issues. Some information on the basics of the legal side of EOLC would be helpful. Part of the discussion surrounding EOLC is to assist the patient in understanding the various components of written documentation of their wishes, such as advanced directives and power of attorney.

Content Accuracy rating: 5

I did not notice any errors in the book, but this is a topic where the statistics supporting the information can easily change over the course of a couple years, so one needs to take into account he authoring year.

Relevance/Longevity rating: 5

Relevance is one of the book's strengths. It is a fairly easy read which should increase the likelihood that the student or healthcare professional will read the entire book. future updates seem quite manageable.

Clarity rating: 5

The author did a great job of writing for a broad audience. It is not overly "medical" and presents the information in such a a manner that most lay individuals could comprehend the book's material.

Consistency rating: 5

The consistency throughout the book is one of the main reasons that a lay individual could easily absorb the content of this book.

Modularity rating: 5

Modularity is another strength of this book. Not only could an instructor assign the various chapters to coincide with a student's progressive matriculation through a program, but each section can stand on it's own and is not dependent on previous content. This lends nicely for faculty that may only want to emphasize certain sections of the book.

Organization/Structure/Flow rating: 4

I believe the organization of this book is excellent, with one exception. In the last section, "Afterword Evaluation of Self: Lessons Learned", the first objective is "Evaluate one's own attitudes and beliefs about death and dying". The author goes on to focus mostly on caregivers that work in hospice, which leaves a gap for many other healthcare professionals, such as those that work in ICU's and ER's. Additionally, I think devoting some time to processing one's own feelings about dying could be beneficial in the beginning of the book.

Interface rating: 5

There are many tables and charts that contribute significantly to the readers understanding of the content, such as the cultural differences (pg. 113-114).

Grammatical Errors rating: 5

No grammatical errors were noted.

Cultural Relevance rating: 5

Lack of perceived cultural sensitivity in healthcare is one reason many patients do not seek care, especially in the end of life stage. This book does an excellent job of bringing that to the forefront and arming the reader with knowledge and examples to feel confident in caring for a variety of patients who culture may differ from their own.

Comments

I enjoyed reading this book and look forward to incorporating the content in my own classes.

Reviewed by Patricia Drees, Assistant Professor, Fort Hays State University on 11/29/18

Comprehensiveness rating: 4 see less

There is no index at the end of the work. There is a list of websites that can be used as resources for further reading.
The topic is covered logically and groups the subtopic by when these topics occur in the life and death experience.

Content Accuracy rating: 5

It is accurate and evidence based. Pain management and ethics are objectively discussed. Pain management is an area of nursing that tends to bring out opinions more than evidence to guide care. This warns against that.

Relevance/Longevity rating: 5

This is relevant to nursing as it expands the topics:
1.fear of death
2.fear of pain in dying
3.accurate information on death process (physiological processes)
4.accurate information on pain medications
5.grief and hope
6.spiritual distress
7.application of ethical principles as related to death and dying

Clarity rating: 5

Accepted and appropriate terms are used. Written in standard American English.

Consistency rating: 5

Yes.

Modularity rating: 5

The educator could easily ask the student to read a section to expand upon what is being taught in class.

Organization/Structure/Flow rating: 5

It flows sequentially using a timeline or several timelines to capture the death and dying process.

Interface rating: 4

Being an online book requires a different sort of navigation. It may require conversion to a format where the student can search out specific parts. I was unable to sign in. I downloaded a PDF. Perhaps, the other format had this feature.

Grammatical Errors rating: 5

If grammatical errors occur, they did not hamper my understanding of the content.

Cultural Relevance rating: 4

It is based on the American death and dying experience. It has a section on cultural care. It is brief and not the most comprehensive resource on that, however, it would not lead the nurse astray if this is the only source of cultural information. It has brief examples of religious and ethnic variations in beliefs and customs.

Comments

If I were teaching health and illness, it would be an adjunct source on pain medications and dying.
As a mental health instructor, I could pick out different sections to supplement and expand topics. The spiritual distress section would be useful. This resource is good to look at the family dynamics of death and dying. I do not have a nursing book in the curriculum that this could 100% replace. The citations after each chapter alone would be a goldmine for students trying to learn more about the topic.

Reviewed by Sandra S. Lee, PhD, RN, CNE, Assistant Clinical Professor of Nursing, University of Houston on 5/21/18

Comprehensiveness rating: 4 see less

The book addresses all areas of end-of-life care, starting with history, frameworks, and models of care. The middle section sufficiently covers the symptoms and corresponding interventions that a hospice nurse would most commonly encounter in the illness trajectory. Although there is not an index or glossary, the table of contents is clear enough to quickly identify and find topics of particular interest.

Content Accuracy rating: 5

The content is accurate and reflects current knowledge and science around end-of-life care.

Relevance/Longevity rating: 5

The content is up-to-date and utilizes reputable sources throughout. A resource list at the end of the text gives the reader links to online sources which are not likely to change, such as the American Geriatrics Society and the American Medical Association, Institute of Medicine, etc.

Clarity rating: 5

The text is refreshing to read. It challenges the reader with expanding knowledge and points of critical discussion and handles a weighty topic in a way that is easy to think about and digest. The narrative is clear and easy to understand yet obviously scholarly and well supported by the current research and literature in end of life care.

Consistency rating: 5

The text is clear and consistent with its terminology and approach.

Modularity rating: 5

What really stands out is the large-font chapter titles, a poignant quote at the beginning of chapters to introduce the reader to the topic, and the learning objectives clearly indicated in a black and white box. The "What You Should Know" key points are easily identified at the end of each chapter by a green box, highlighting the most important take-aways from each chapter. References follow each chapter.

Organization/Structure/Flow rating: 5

Each chapter begins with large-font chapter titles and a poignant quote at the beginning of chapters to introduce the reader to the topic. The learning objectives are clearly indicated in a black and white box. The "What You Should Know" key points are easily identified at the end of each chapter by a green box, highlighting the most important take-aways from each chapter. Each chapter is organized in the same way, so the reader knows what to expect while progressing through the text.

Interface rating: 5

The interface is excellent. The no-frills approach in a PDF allows easy download and storage onto multiple device. I enjoyed reading the book on my iPhone. The reader won't find complicated graphics, images, or interactive activities in the text. Instead, Dr. Lowey opted for a simple, streamlined approach that I found aesthetically pleasing and easy to navigate between chapters. Charts and graphics are carefully selected and strategically placed wtih full explanations.

Grammatical Errors rating: 5

No grammatical or formatting errors were noted. The text is easy to read yet employs professional language and terminology.

Cultural Relevance rating: 4

The book approaches the subject of end of life care with sensitivity, knowing that many nurses are not comfortable with the topic or their ability to provice sufficient care. Dr. Lowey assures readers of all experience levels that the nursing hesitancy and limited of knowledge in end of life care is widespread. She empowers the reader that our presence and voice is our greatest and most effective intervention during end of life care. A specific chapter addresses the diversity and death practices across cultures and summarizes the religious beliefs for each of the world's major religions. No book or chapter could possibily comprehensively consider all cultural beliefs around death, dying, and funerals, but Dr. Lowey gives us a good starting point.

Comments

Nursing Care at the End of Life: What Every Clinician Should Know is a real gem for nursing students, experienced clinicians, and those new to hospice care. Having such an outstanding resource in the Open Textbook Library is a gift to the nursing profession, and to our patients. The text gives a practical, relevant, well-written, and comprehensive resource to draw upon when caring for patients in the palliation/hospice trajectory. The very best chapter is the last one in which Dr. Lowey reflects on what it's like to be a hospice nurse, how she copes with her own sadness when patients die, and other common questions that hospice nurses are often asks. If a nurse is thinking about becoming a hospice nurse and reading this book to get information, the last chapter will clearly help guide the decision. Several chapters could stand alone as reading assignments in other courses such as medical-surgical nursing or psychiatric care, or a course addressing cultural aspects of care. Whether used in its entirety, in part, as required or optional, this text is a must have in every nursing education program. I definitely plan to use this text in my classes for both required and optional reading assignments. Great job and outstanding work, Dr. Lowey!

Reviewed by Nancyruth Leibold, Associate Professor, Southwest Minnesota State University on 2/1/18

Comprehensiveness rating: 5 see less

Nursing Care at the End of Life: What Every Clinician Should Know is a comprehensive book about caring for patients and families at the end of life. All areas and ideas related to nursing care at the end of life are included. A Table of Contents is included. An Index and Glossary are not included in this textbook.

Content Accuracy rating: 5

The textbook includes accurate information about end of life care that is supported with evidence from the literature. The content is free of errors and unbiased

Relevance/Longevity rating: 5

Nursing Care at the End of Life: What Every Clinician Should Know is relevant information as information about End-of-Life case is important for health care professionals to know and apply when caring for patients and their families at end-of-life. The content will not be quickly outdated, which is a major concern in nursing topics.

Clarity rating: 5

Nursing Care at the End of Life: What Every Clinician Should Know is clear and easy to read. The book includes professional vocabulary, but defines the terms used.

Consistency rating: 5

Consistent terms and frameworks are used throughout the book.

Modularity rating: 5

Nursing Care at the End of Life: What Every Clinician Should Know is presented in smaller reading sections with headings and subheadings to divide up the chunks of content. The book is not overly self-referential. Dr. Lowey cites her work in this area, but it is not overdone.

Organization/Structure/Flow rating: 5

Nursing Care at the End of Life: What Every Clinician Should Know is well organized and flows well. There are 12 chapters in the text. Each chapter includes learning objectives, content, a “What You Should Know” section, and references. The major sub-topics for end of life care are included. And Afterword and End of Life Care Resources section is included. The tables and figures are helpful and point out the key ideas.

Interface rating: 5

When I read the book in the online format, the font changed to difficult to read fonts and also changed to italic for some chapters. I found this difficult to read. The figures and tables were not impacted. I recommend using the PDF format of the book for this reason as it was consistent and easier to read. This may have been some odd technical aberration, but did happen to me at several different checks on different days. However, I mention in case you have similar issues so you can try the PDF as another option. Being able to download the PDF is an awesome plus!

Grammatical Errors rating: 5

The book is free of grammar and spelling errors.

Cultural Relevance rating: 5

This book includes a chapter about Diversity in Dying. The chapter outlines various religious beliefs and practices related to death and dying. Nurses are told to become familiar with the death and dying practices of the family. This is appropriate because families will have their own cultural practices that may or may not be used by everyone of their culture or religious affiliation.

Comments

Nursing Care at the End of Life: What Every Clinician Should Know is a well written book with outstanding content and organization. Thanks to Dr. Lowey for this open educational resource!

Reviewed by Dawn Cullison, Assistant Professor, Reynolds Community College Richmond, Virginia on 2/8/17

Comprehensiveness rating: 5 see less

This book is very comprehensive and the author's scaffolding of foundational to more complex concepts yields a very thorough and yet concise understanding of the content.

Content Accuracy rating: 5

This book contains very well researched, current, and unbiased information, allowing the reader to glean an understanding of the various theories of death and dying and the myriad of approaches to the care of the dying patient.

Relevance/Longevity rating: 5

The content of this text is current, relevant, and most essential in the training of nursing students and is written in such a manner as to not require frequent updates. The content is applicable to all facets of nursing as death and dying are encountered in any given specialty within the nursing profession. This text serves to fill in the gaps of coverage of death and dying in many nursing programs and would also be of benefit to the practicing nurse who desires to pursue additional independent learning opportunities.

Clarity rating: 5

The text is written in a manner consistent with educational resources aimed at the target population of nursing students, however, even one not familiar with nursing jargon/technical terminology would benefit from reading and be able to understand the overall intent of the text.

Consistency rating: 5

This text is divided into very concise chapters and utilizes a consistent framework throughout, which allows the reader to quickly identify the author's given style of writing, yielding an ease of comprehension and expeditious sense of familiarity and understanding.

Modularity rating: 5

This text is written in a format of very concise, modular sections which could easily be dissected and read in part, but also as a whole. The text references multiple sources of a wide range of expertise, offering the reader many opportunities to explore a particular topic of interest in greater depth.

Organization/Structure/Flow rating: 5

The topics are presented in a clear, logical, and systematic manner, allowing the reader to either review or learn afresh the foundational principles and then move deeper into the more complex and finely tuned content.

Interface rating: 5

This text is free of any significant interface issues, and no distortions of content, images, or charts is noted. The text was downloaded without difficulty and the formatting is clear, consistent, and reader-friendly.

Grammatical Errors rating: 5

The text contains no grammatical errors.

Cultural Relevance rating: 5

This text is culturally sensitive and addresses the unique differences in terms of cultural or religious views of death and dying while avoiding generalizations. The text seeks to educate the reader on the wide range of patient, family, and health care professional responses to death and dying while also avoiding generalization. This facet allows the reader to glean insights without forming potentially inappropriate or inaccurate presuppositions when faced with other cultures or religions in practice.

Comments

This book is an invaluable resource to all nursing students and practicing nurses as it very concisely articulates the unique complexities encountered in the care of the dying patient and the dying patient's family. This book accurately asserts that the content explored in this text is often covered minimally in the traditional nursing curriculum, leaving many nurses feeling inadequate, unprepared, and less than confident when caring for the dying patient in practice. This book more than adequately fills the void and I will be utilizing this resource in the future. Thank you for compiling and sharing this information.

Reviewed by Cindy Yascavage, Instructor, Temple University on 8/21/16

Comprehensiveness rating: 5 see less

The text is comprehensive and appropriately provides a basic understanding of terms of a difficult topic for care givers.

Content Accuracy rating: 5

The book's content is accurate and supported appropriately with relevant references.

Relevance/Longevity rating: 5

Even though some of the material seemed old, it is the gold standard. The content is up to date, and somewhat ageless. Medications for pain may change, however, learning how to manage palliative care clients remains difficult for many.

Clarity rating: 4

There text is not written with techinical terminology such as medical procedures, however, to a nonmedical person, there might be some terminology they are unfamiliar with.

Consistency rating: 5

The text is consistent in terminology and framework throughout the text. For example each chapter begins with learning objectives.

Modularity rating: 5

The text is easily divided into smaller section that are managable for assignments.

Organization/Structure/Flow rating: 5

The text is organized and presented in a logical and clear fashion.

Interface rating: 5

The text is free of significant interface issues. There were not any navigation or chart distortion issues on computer or phone display access.

Grammatical Errors rating: 5

The text was written without any noticeable grammatical errors. It was written at a level that a nurse could share the text with a family member and they could understand the information.

Cultural Relevance rating: 5

The text touches on a cultural diversity and end-of-life care in a very non-offensive way.

Comments

This text is a great addition to any course that discusses end of life. It touches on hospice and palliative care, as well as pain control when dying, all in one text. Many texts are lacking this combination.

Reviewed by Michael Torguson, MS, MA, Bioethicist; Past Chair for Education & Policy - Ethics Committee, Rogue Valley Medical Center (Medford, Oregon) on 8/21/16

Comprehensiveness rating: 5 see less

Health Care is - by definition - a profession that is focused on preventing the end of life. This text aims to guide health care providers through the inevitable process that all patients will experience, divided into stages of care: Anticipation, In The Moment, Afterwards.

Content Accuracy rating: 5

Content is presented in as unbiased a manner as is possible with such a high-emotion subject.

Relevance/Longevity rating: 5

Content is very timely and up to date. There are some references that are older (greater than 10 years), but they are included in such a way that the age of the study does not detract from the predominant thesis in each chapter.

Updating the work to include the latest trends in best clinical practices should not be difficult, as the compartmentalization of the information - while building on previous learning - is not so interwoven as to substantially detract from the flow of the narrative.

Clarity rating: 5

Written in such a way as to be accessible to a layperson not clinically trained, but also not too basic for the healthcare provider, the text is clear, concise, and accessible to the reader. When complex clinical information is presented, it is not dumped on the reader; rather there is a "ramp up" feel to the content.

Consistency rating: 5

There is good consistency in the book, as well as mercifully few "callback" references to earlier chapters.

Modularity rating: 5

The three main content areas (Units?) work well to guide the clinician through the process of learning about the end of life process. Within each of these units, however, the individual chapters - upon first reading - seem to require the healthcare provider to take each chapter in order. Once read and when the content is familiar, however, the chapters are useful as stand-alone references.

Organization/Structure/Flow rating: 5

Highest marks for the organization and flow of the book. Leading the clinician through the death and dying process in a chronological "presentation of symptoms" order makes the text exceptionally well suited for this subject. Again, once the healthcare provider is familiar with the text, then accessing specific information in non-sequential chapters is not only possible, but easy.

Interface rating: 5

This reviewer experienced no problems with the format of the text.

Grammatical Errors rating: 5

No errors in grammar, punctuation, or sentence structure/mechanics.

Cultural Relevance rating: 5

No text can be all things to all people. This text manages to hit the "middle of the bell-shaped curve" in that it is applicable to most people under most circumstances, most of the time. The Ethics chapter will be the most "controversial," as Ethics is - by definition - a morality based, Right-And-Wrong subject. Further, there is no overtly judgmental language when dealing with controversial topics (withdrawing/withholding care, assisted dying, etc.). Being from Oregon, I would have personally liked to see more than one paragraph on assisted suicide, but the author's treatment of the subject is satsifactory.

Comments

The layout of each chapter is especially useful. Starting with learning objectives bullet points, the author guides the reader through the content, then wraps up each chapter with three main bullet point "Things You Should Know." The text lends itself to note taking and information retention. Overall, a good text that will be useful to clinicians working with end of life patients, as well as a helpful adjunct for those in the healthcare realm (long term care, acute care, ethics committee, etc.) to supplement their understanding of the issues.

Reviewed by Tina Davis, Health Faculty, Lane Community College on 8/21/16

Comprehensiveness rating: 5 see less

This book is very comprehensive in its coverage of the topics of nursing at the end of life. And although the book does not include a separate index or glossary, it does provide plenty of terms and definitions within the text in a thoughtful and organized manner. The website resources at the end is comprehensive.

Content Accuracy rating: 5

I found the accuracy of this book to be excellent. With the exception of one small error of two words joined together, I found no other errors. And the inclusion of various perspectives provides an unbiased view of nursing in this context.

Relevance/Longevity rating: 5

The relevance to today's nursing field and hospice care is extremely up-to-date. Having experienced my mother's and father's hospice care at different times within the last six years, I found the advice and information affirming and relevent. Obsolescence is easily avoided with supplementing information when it is necessary. The personal experiences and examples are timeless.

Clarity rating: 5

The terms were clearly defined and the examples provided the helpful context. The prose was very accessible and easy to follow and enjoyable to read without being too wordy or technical. For example, p. 60 clearly gives a thorough description of the classifications of pain and differentiating between the mechanisms and temporal patterns.

Consistency rating: 5

Each chapter is nicely framed, beginning with the objectives and moving to an introduction and the main ideas, then finishing with "what you should know." This framework provided an easy-to-follow pattern.

Modularity rating: 5

The book's modularity is wonderful. The three main parts I. Anticipation II. In The Moment and III. Afterwards provides structure of the individual chapters and their focus. This allows instructors to easily assign readings in individual sections. And the subheadings within the chapters are very useful.

Organization/Structure/Flow rating: 5

The organization of the book showed topics divided into a simple sequence related to the care of the patient. The three major sections clearly follow the sequence related to the care of the patient. The chapters within the sections are logically divided and clearly presented. The subheadings within the chapters also makes it easy to find individual topics. And even though this book may target nurses, it is organized in a useful fashion for the patient and family member as well.

Interface rating: 5

The figures and tables are nicely formatted and easy-to-read. The Models of Care (p. 39) figures were a bit confusing at first but the explanation in the text following the figures was provided and made it more clear. The tables provided easy-to-reference guides for such areas of questions to ask the patient as well as religious beliefs about death and dying.

Grammatical Errors rating: 5

I found no grammar errors and the language used corresponded to the nursing field but also provided concrete examples for the lay person.

Cultural Relevance rating: 5

The book mentioned consideration of different groups of people with its definition of 'diversity' on p. 109. It also provided different religious perspectives of death and dying in the chapter on Diversity and Dying. But more importantly the language and style of the book continually used phrasing of 'inclusiveness' and repeatedly cautioned the nurse to be aware of the care and communication with the patient and family so as not to offend or exclude anyone based on different cultural or ethnic backgrounds.

Comments

This book is a valuable resource for anyone, not just a nurse or caregiver, patient or family member of a patient. Its comprehensiveness and validity can be summed up with Susan Lowey's reminder about the importance of care a dying patient receives and how it may not be remembered by the nurse, but it will surely be remembered by the patient's family (p.94).